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The guidelines for the management of SE produced by the Italian League against Epilepsy also distinguish three different stages of SE (initial, established and refractory), based on time elapsed since the onset of the condition and responsiveness to previously administered drugs. Treatment should be started as soon as possible, particularly in generalized convulsive SE, and should include general support measures, drugs to suppress epileptic activity and, whenever possible, treatments aimed at relieving the underlying (causative) condition. Benzodiazepines are the first line antiepileptic agents, and i.v. lorazepam is generally preferred because it is associated with a lower risk of early relapses. If benzodiazepines fail to control seizures, i.v. phenytoin is usually indicated, though i.v. phenobarbital or i.v. valproate may also be considered. Refractory SE requires admission to an intensive care unit (ICU) to allow adequate monitoring and support of respiratory, metabolic and hemodynamic functions and cerebral electrical activity. In refractory SE, general anesthesia may be required. Propofol and thiopental represent first line agents in this setting, after careful assessment of potential risks and benefits.<\/jats:p>","DOI":"10.1111\/j.1528-1167.2006.00870.x","type":"journal-article","created":{"date-parts":[[2006,12,14]],"date-time":"2006-12-14T07:30:03Z","timestamp":1166081403000},"page":"9-15","source":"Crossref","is-referenced-by-count":59,"title":["Treatment of Status Epilepticus in Adults: Guidelines of the Italian League Against Epilepsy"],"prefix":"10.1111","volume":"47","author":[{"given":"Fabio","family":"Minicucci","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Muscas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Perucca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Capovilla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Vigevano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Tinuper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,12,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.01.017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(93)90135-X"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa002141"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1995.tb15014.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.1.47"},{"key":"e_1_2_10_7_1","first-page":"915","article-title":"Drug therapy reviews: drug therapy of status epilepticus","volume":"35","author":"Browne TR","year":"1978","journal-title":"American Journal of Hospital Pharmacy"},{"key":"e_1_2_10_8_1","first-page":"671","article-title":"Visualization of evolving status epilepticus with diffusion and perfusion MR imaging","volume":"24","author":"Calistri V","year":"2003","journal-title":"American Journal of Neuroradiology"},{"key":"e_1_2_10_9_1","first-page":"1274","article-title":"Treating repetitive seizures with a rectal diazepam formulation: a randomized study","volume":"51","author":"Cereghino JJ","year":"1998","journal-title":"The North American Diastat Study Group. 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